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  From the Desk of Editor–in–Chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …

eMediTube (videos), eMedipics, eMediSlide, eMediLaw

  Editorial …

28th February 2013, Thursday

Should I go for a knee replacement?

Yes if

  1. I am no longer able to do my routine work without help
  2. I have pain that keeps me awake at night despite the use of drugs
  3. I have pain that keeps me from being able to walk or bend over
  4. I have pain that isn’t relieved by rest
  5. I have pain that is not responding to non-surgical approaches.
  6. I have been told that less-complicated surgical procedures are unlikely to help.
  7. The disease osteoarthritis is wearing me down physically, emotionally, and mentally.
  8. I am suffering from severe side effects from the drugs
  9. Advanced arthritis is demonstrated on my test
  10. If significant joint damage has occurred on my tests.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

What is the approach to evaluation of a patient with constipation?

A comprehensive physical examination should be performed that includes a rectal exam to palpate for hard stool, assess for masses, anal fissures, hemorrhoids, sphincter tone, push effort during attempted defecation, prostatic hypertrophy in males and posterior vaginal masses in females.

For comments and archives

Dr K K Aggarwal
  eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

Daily aspirin to prevent heart disease may increase risk of GI or cerebral bleeding

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

eMedinewS shares the pain of the untimely demise of Dr N K Grover Past National President IMA on 27th Feb. He gave his last inspiring speech on 18th Feb at IMA. May God give courage to all of us and the family members to bear this great loss.

Dr K K Aggarwal
    National News

Homage to Past President National IMA

Dr NK Grover is no more with us Yesterday we lost our near and dear, Dr NK Grover, Past President National IMA. May God give strength to the bereaved family and all of us to bear this great loss. His last address to the IMA was on the night of 18th February, following which he had acute MI and never came out of it. Dr NK Grover was instrumental in the fight against Consumer Protection Act (CPA). A condolence prayer was held at Delhi Medical Council today. A condolence meet would be held on Sunday 3 pm at IMA Headquarters jointly by the IMA and DMA. For more Pics

No polio cases reported in last nine years: Tamil Nadu

Chennai: Tamil Nadu government on Saturday said the state has not reported a single polio case in the last nine years, as it prepares for the second round of Pulse Polio Campaign in which two lakh personnel would be employed.

In the first round of the polio campaign held on January 20 last year, 70.30 lakh children under the age of five years were administered with polio drops, state Public Health Secretary J. Radhakrishnan said, adding, the second round of the immunisation programme was scheduled to begin from Sunday.

“Tamil Nadu has not reported any polio case for the past nine years. However, it is very much important to administer polio drops to all children during Pulse Polio Campaign in order to protect children from possible importation of Polio virus from other parts of the Country/World,” he said in a statement.

Elaborate arrangements have been made for the second round, which involves administering drops to children covered in the first round also, he said, adding, 40,000 booths have been established across the state for this purpose.

Over 1000 transit booths will be functioning in major bus stands, railway stations and airports during the campaign days to cover children on travel. These booths would function for three days, he said.

Further, 771 mobile teams will serve “remote and inaccessible areas,” and about two lakh personnel from various government departments besides NGOs would be involved in the “mega campaign”, he said. (Source: The Hindu, February 23, 2013)

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Be Human Stop Child Abuse (Team IMA for CMAAO)


For adolescent girls who have been sexually abused testing for STI should be made on a case by case basis.

For comments and archives

    Valvular Heart Disease Update

Errors in diagnosing MR severity

  • Severe chronic MR does not exist without left atrial or left ventricular enlargement
  • If LVEDD (Left ventricular end–diastolic diameter) is <60 (35 mm/m2), then revise the diagnosis of severe chronic MR
  • Left atrial enlargement defines the severity and duration of chronic MR

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

    International News

(Contributed by Dr Monica and Brahm Vasudev)

FDA approves Atrial sensing one-lead ICD

The FDA has approved Biotronik's Lumax 740 DX, a first-in-class, single-lead implantable cardioverter defibrillator (ICD) that senses atrial arrhythmias. (Source: Medpage Today)

Nicotine vaccine promising for smoking cessation

An experimental nicotine vaccine reduces the amount of nicotine that reaches the brain and binds to nicotinic acetylcholine receptors (nAChRs), helping to reduce cigarette use and cravings, new research shows. However, at least 1 expert has some misgivings about its potential as an effective treatment. (Source: Medscape)

FDA OKs drug for postmenopausal dyspareunia

The US Food and Drug Administration (FDA) has approved ospemifene (Osphena, Shionogi, Inc) for treating moderate to severe dyspareunia in postmenopausal women, the agency announced today. (Source: Medscape)

Spironolactone disappoints in preserved-EF HF: Aldo-DHF in print

A year of aldosterone blockade failed to improve exercise capacity, symptoms, or quality-of-life measures in a placebo-controlled trial of >400 patients with heart failure and LV ejection fractions >50%. However, spironolactone treatment in the study led to significant gains in echocardiographic measures of diastolic function. (Source: Medscape)

Advanced breast cancer now more common in younger women

The number of young women presenting with metastatic breast cancer has been slowly but steadily rising over the past 3 decades, a national study found. (Source: Medpage Today)

    Twitter of the Day

@DrKKAggarwal:Ashok Saha from LIC doing CPR 10 pic.twitter.com/nAaCT98E3c

@Dr Deepak Chopra: There is no provable link between “This is what I see” & “This is real.” My article was published by SF Gate http://tinyurl.com/aztzs2z

    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Why do we light a lamp during pooja?


|| Deepajyothi parabrahma

Deepa Jyotir Janaardanah

Deepo harati paapaani

Sandhyaa deepa namostute

“I prostrate to the dawn/dusk lamp; whose light is the Knowledge Principle (the Supreme Lord), which removes the darkness of ignorance and by which all can be achieved in life.”

For comments and archives

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the success rates of IUI?

The success rates with donor insemination depend on many factors. These include the female age and the presence of other female fertility factors such as endometriosis, tubal disease, or ovulatory dysfunction. In general, the monthly chance of pregnancy ranges from 8–15%. The risk of birth defects as a result of conceiving with donor insemination is no different than from conceiving naturally, and is in the range of 2–4%.

    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

What is hemoglobin?

Hemoglobin is a protein present in the red cells. It helps to carry oxygen and carbon dioxide. On an average, in a healthy male it should be between 14 – 16 gm/dL and in a female it should be about 12 – 14 gm/dL. Hb is synthesized daily and new Hb is replacing the old store.

For comments and archives

    An Inspirational Story

The Trouble Tree

The carpenter I hired to help me restore an old farmhouse had just finished a rough first day on the job. A flat tire made him lose an hour of work, his electric saw quit, and now his ancient pickup truck refused to start.

While I drove him home, he sat in stony silence. On arriving, he invited me in to meet the family. As we walked toward the front door, he paused briefly at a small tree, touching the tips of the branches with both hands.

After opening the door, he underwent an amazing transformation. His face was wreathed in smiles, and he hugged his two small children and then gave his wife a kiss.

Afterward, he walked me to my car. We passed the tree, and my curiosity got the better of me. I asked him about what I had seen him do earlier.

“Oh, that’s my trouble tree,” he replied. “I know I can’t help having troubles on the job, but one thing for sure, troubles don’t belong in the house with my wife and children. So I just hang them up on the tree every night when I come home. Then in the morning, I pick them up again.”

“Funny thing is,” he smiled, “when I come out in the morning to pick them up, there aren’t nearly as many as I remember hanging up the night before.”

What do you think about the way the carpenter chose to deal with his problems? What do you think he accomplished by leaving his troubles outside of his home?

For comments and archives

    Cardiology eMedinewS

White matter hyperintensities linked to Alzheimer's disease Read More

Vitamin D Facts Read More

    Pediatric eMedinewS

Air pollutants linked to asthma-related epigenetic changes Read More

AAP outlines fetal damage with drug abuse Read More

    Rabies Update

Dr. A K Gupta, Author of "RABIES - the worst death", Joint Secretary, Association for Prevention and Control of Rabies in India (APCRI)

What are the contraindications to post exposure prophylaxis?

As rabies is 100% fatal, there are no contraindications to post exposure prophylaxis.

    IJCP Special

Dr Good Dr Bad

Situation: A patient with Mediclaim for the last seven years came for executive checkup.
Dr. Bad: You will have to pay from your pocket.
Dr. Good: You can claim it from Mediclaim.
Lesson: In addition to cumulative bonus, the insured shall be entitled for a reimbursement of the cost of medical checkup once at the end of block of every four underwriting years provided there are no claims reported during the block. The cost so reimbursable shall not exceed the amount of 1% of the total amount of the average sum insured during the block of four claim free underwriting years.

Make Sure

Situation: An asthmatic patient became worse after receiving a painkiller.
Reaction: Oh my God! Why was he not put on a leukotriene receptor antagonist?
Lesson: Make sure that a patient with asthma is not given aspirin or he is put on a leukotriene receptor antagonist.

  Quote of the Day (Dr GM Singh)

When you are at a loss of what to do, do nothing. Doing nothing can be very wise. When you pause doing things, you become more aware of God’s presence, and often an unexpected solution to your question will arise.

    Mind Teaser

Read this…………………

Biofeedback is a therapy used to:

A. Develop psycho-physiologic self-regulation.
B. Enhance drug delivery.
C. Increase release of serotonin.
D. Promote neuronal regeneration.

Yesterday’s Mind Teaser: A focused examination for fibromyalgia includes assessment for:

a. Autonomic changes, peripheral neuropathy, and skin fold tenderness
b. Morning fatigue, widespread body pain, and focal tenderness
c. Skin rashes, edema, and constipation
d. Unilateral weakness, hyperesthesia, and allodynia

Answer for Yesterday’s Mind Teaser: b. Morning fatigue, widespread body pain, and focal tenderness

Correct answers: Dr B K Agarwal, Dr. Bharat Bhushan Aggarwal, Dr Kanta jain, Dr. P. C. Das, Dr. Thakor Hitendrsinh G, Dr.(Maj. Gen.) Anil Bairaria, Dr Pankaj Agarwal, DR ARPAN GANDHI, Muthumperumal Thirumalpillai, Prabha Luhadia, Dr Avtar Krishan

Answer for 26th February Mind Teaser: b. Immediate release morphine (MS IR)

Correct answers received from: DR Chandresh jardosh, Dr Valluri Ramarao

Send your answer to ijcp12@gmail.com

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Photos and Videos of 4th eMedinewS – RevisitinG 2012 on 20th January 2013

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    Laugh a While (Dr GM Singh)

Father is a lawyer...

While in Atlanta on vacation, Little Johnny's Daddy took one afternoon to see historic sites downtown.

Two young families were also in line to the see the sites. Little Johnny struck up a conversation with one of the boys in line.

"My name is Tommy. What's yours?" asked the first boy.


"My Daddy's an accountant. What does your Pop do for a living?" asked Tommy.

Little Johnny replied, "My Daddy's a lawyer."

"Honest?" asked Tommy.

Johnny replied, "No, just the regular kind."

    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

What is lucid interval?

Lucid interval is the period during which the mentally unsound person behaves very much like a normal person. During this period all the signs and symptoms of insanity are absent. The person is responsible for all his acts performed during the period of lucid interval.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Turmeric can prevent heart failure

Traditional Indian turmeric prevents heart failure, lowers cholesterol, prevents cancers and gall stones and augments scar formation in a wound, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

Studies from the University of Toronto’s Cardiology Division and published in The Journal of Clinical Investigation have shown that Curcumin, an ingredient in the curry spice turmeric, when given orally to a variety of mouse models with enlarged hearts (hypertrophy), could prevent and reverse hypertrophy, prevent heart failure, restore heart function and reduce scar formation.

In the studies, curcumin was given to rats, who then underwent surgery or received drugs designed to put them at risk of heart failure. The rats that received curcumin showed more resistance to heart failure and inflammation than comparison groups of rats that did not get curcumin.

Curcumin treatment also reversed heart enlargement. Curcumin short–circuited the heart enlargement process, though it’s not clear how it did that.

The healing properties of turmeric have been well–known. The herb has been used in traditional Indian medicine to reduce scar formation. For example, when there is a cut or a bruise, the home remedy is to reach for turmeric powder because it can help to heal without leaving a bad scar.

Curcumin has come under the scientific spotlight in recent years, with studies investigating its potential benefits for reducing cholesterol levels, improving cardiovascular health and fighting cancer.

As an herb, turmeric should to be taken 300 mg thrice–daily with meals. It has useful actions like antioxidant, anti–inflammatory, anti rheumatic; lowering cholesterol, anti cancer and prevention of gall stones. It is also found to be useful in situations like dysmenorrhea, dyspepsia, HIV, muscle soreness, peptic ulcer disease, scabies and uveitis.

Curcuminoids, act as free radical scavengers. They also inhibit leukotrienes and synthesis of prostaglandins. The anti–inflammatory activity has been claimed to be comparable to NSAIDs (such as indomethacin).

Curcuminoids lower blood lipid peroxides, decrease total cholesterol and LDL cholesterol, and increase HDL cholesterol. Turmeric has also been claimed to inhibit platelet aggregation.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 29929 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”

    Readers Responses
  1. Reference Comments on Prosthetic Valve Obstruction: Prosthetic valve thrombosis is the most common cause in our country due to inadequate anticoagulation follow up. One dictum is that that you will be right 3 out of 4 times if you diagnose thrombus over pannus. This will then be supported by history of short onset of symptoms, progressive increase of symptoms, strongly related to inadequate anticoagulation. Transesophageal echo and fluoroscopy are important means of diagnosis by showing abnormal prosthetic valve motion. Even in case of some some doubt administering a rapidly acting thrombolytic agent may be life saving. Dr.Parashar
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